Transdermal fentanyl patches such as Duragesic and Ionsys can create a powerful dependency. They may cause unpleasant side effects such as anxiety, confusion, dizziness, and stomach pain.[1] You might be prescribed fentanyl if you have chronic pain. Fentanyl is prescribed only to "opioid tolerant" patients who have used other forms of narcotic pain relief.[2]. If you were being treated with fentanyl and no longer need it or you need continuing pain medication but no longer want to use fentanyl, talk to your doctor about gradually reducing your dose or switching your medication. If you have become addicted to fentanyl, by itself or combined with other narcotics, talk to your doctor or get evaluated at a rehabilitation center.

Steps

Method1

Reducing Your Dose

1

Talk to your doctor. Fentanyl is a powerful drug, and coming off of it takes time and support. If you have been using fentanyl regularly, do not attempt to get off fentanyl on your own, as you may experience serious withdrawal side effects.[3] Your doctor will come up with a schedule for you to gradually decrease your dosage.

2

Obtain a prescription for lower doses. Your doctor will prescribe you patches in lower doses than the patches you have. Use these patches. Do not attempt to lower your dose by cutting your patches in halves or quarters. Fentanyl patches may release their medicine faster when cut, which could cause overdose and heart failure.[4]

Almost all fentanyl patches are "reservoir" patches, meaning the medication is pooled inside and will release quickly when the patch is cut.

Do not cut matrix system patches. Some users believe it can be done, but the manufacturer warns against it, and no studies recommend it.[5]

Cutting a patch may also damage its sticking power, which could cause it to come off while you sleep and interfere with its effectiveness.

3

Follow a schedule. Your doctor will likely give you a schedule that cuts your dosage over time. This may take weeks or months, depending on the nature of your pain and the length of your fentanyl usage. For example, if you take a 50mcg patch, you might switch to a 25mcg after two weeks, then a 12mcg two weeks later.

4

Take other medication. Your doctor may prescribe you other medication to help you come down from fentanyl. This might be pain medication to help with breakout pain, such as Vicodin. You might also be prescribed anti-anxiety medication to help control shaking and other withdrawal symptoms. Use these as prescribed.

5

Let it go. When you apply your last 12mcg patch, leave it on until it falls off. Even if you've been changing them every 72 hours, leave the very last patch on until it comes off on its own. Because the medicine is weakest when your patch is oldest, it will let you down more gently than if you were to suddenly remove the patch.

6

Prepare for withdrawal. Fentanyl is physically addictive, and can become psychologically addictive. Prepare for serious withdrawal symptoms as you reduce your dose. Take time off from work if you are employed. The first 48 hours after the fentanyl leaves your system are the worst, and that after that time the withdrawal will have peaked and symptoms will begin to subside. Make sure you have your doctor's number on hand so you can consult with her if any symptoms begin to worry you.

Prepare a comfortable nest for yourself for the worst of it. Launder your softest clothing, rent movies, and prepare the foods that you can eat even when you are nauseated from pain.

Have friends and family around for support if possible.

Go online and join a forum for current and former fentanyl patients. Forums with users across the globe are a great resource for sleepless nights brought on by withdrawal.

As the withdrawal symptoms lessen, light exercise will help keep you centered. Take a walk around the block. Do yoga exercises or stretch at home, or in class if you feel up to it.

7

Look out for side effects. If you experience worrisome side effects after you are off fentanyl, contact your doctor immediately. Hallucinations, chest pain, fainting, mood swings, difficulty walking, speaking, or urinating, rapid weight gain, and spitting blood are all considered worrisome symptoms. If you think you may have had a seizure, call an ambulance and go immediately to urgent care.[6]

Other side effects may include increased sweating, increased heart rate, anxiety, restlessness, and stomach pain.

Method2

Switching Pain Medications

1

Talk to your doctor. If you do not like your patch and would like to use a different method of pain management, talk to your doctor about switching you to a different pain medication. If you would like to switch to a lower dose, your doctor might choose to switch you to an equivalent amount of a new opioid, then wean you off of that.

Depending on the type of pain you are in, the side effects you want to avoid, and the medications covered by your insurance, your doctor will advise you on the right alternative and devise a conversion plan.

Your doctor might want to switch you to oral morphine, oxycodone, or methadone.

Do not switch medications or stop taking your medication before consulting your doctor.

2

Wait till the medicine is in your home. When your doctor prescribes a new medicine, he may advise you to start cutting your dose of fentanyl. Make sure you do not begin decreasing your dose until your replacement medication has arrived in your home. A prescription does not guarantee delivery. You will put yourself at risk of pain if you cut your fentanyl dosage and your new medicine does not arrive on time.[7]

3

Remove the patch. When the medicine is in your home, and your doctor has given you the order, remove your patch. Dispose of it safely as you always do. Your doctor may advise you to wait until you have worn through your current patch and it comes off. She may also advise you not to wait. Follow your doctor's orders as to timing.

4

Phase in your new medication. When you remove the patch, the fentanyl will still be in your system, so you won't need as much of your new medication at first. Your doctor will prescribe you a "rescue" opioid for the first 12 hours after your patch is removed. After this 12 hours, you will likely be told to begin taking 50% of your new dose. After 24 hours, you will start taking 100% of your new dose.

After the first 12 hours, you can still take your "rescue" opioid if you experience a pain crisis.

5

Follow up. Schedule a follow up appointment with your doctor before you have been off of your patch for a week. Your new medication may take a while to start working, or it may work well at first and then cease to be effective. Ensure that you have a means to get to the hospital if you experience a crisis your rescue opioid cannot cover.

If you find you have become addicted to your fentanyl patch, consider entering a rehabilitation program.

Prepare for withdrawal. Even using new medication, you may experience withdrawal symptoms. Take time off to get used to your new medication, and rally family and friend support.

Method3

Kicking an Addiction

1

Recognize an addiction. Fentanyl is highly addictive. If you are using your prescription after your doctor has recommended you stop, or making the unsupported decision to increase your dosage, ask yourself if you are addicted. If you find yourself concealing your fentanyl use or otherwise acting surreptitiously or dishonestly to be able to obtain or use fentanyl, you may be addicted. If you are consuming fentanyl that you obtain from someone other than your doctor, you are likely addicted.

Fentanyl is often stolen from hospitals, pharmacies, and nursing homes.[8]

On the street, fentanyl is known as "rizzle," "gems," "china," "dance fever," "goodfella," "china girl," "TNT," "tango," "apache" and other names. It is sold by itself or mixed with other drugs.

If you find yourself buying fentanyl from dealers, consider visiting a detox center.

2

Get inpatient care. Check into an inpatient facility for an immersive rehabilitation experience. In an inpatient facility, you will be in the company of other patients. You will have access to therapists and round-the-clock care. Your length of stay depends on your needs. After your detoxification, which may last a week, you can stay for anywhere from three weeks to three months.[9]

Supervised detoxification is safer than unsupervised detoxification, and your doctor may recommend it.

Inpatient care is a great option for patients whose home life is either unstable or distracting.

Consider joining a meet-up group or checking into an outpatient program to prevent relapse after completing inpatient therapy.

3

Get outpatient care. There are several kinds of outpatient programs to choose from. "Intensive programs" meet several times a week for several hours a session and focus on preventing relapse. "Partial hospitalization" will have you visiting a hospital for several hours a day three to five days a week. Therapy and 12-step programs such as Narcotics Anonymous are also considered outpatient treatment.[10]

If you cannot afford inpatient care or to take time off work, consider outpatient care.

If you need continuing care after kicking an addiction, consider outpatient care.

If your home life is stable and supportive, and you feel you need the continuing support of your friends and family to commit to rehabilitation, consider outpatient care.

4

Take methadone or buprenorphine. Talk to your doctor or a rehabilitation specialist about taking methadone or buprenorphine to ease your addiction. Locate a methadone or buprenorphine center near you and ask for a clinical evaluation. If you have been using opioids such as fentanyl for a long time, methadone might be more effective than buprenorphine.[11]

5

Find affordable rehab. Many rehabilitation centers are government funded or nonprofit. They may offer their services for free, or charge on a sliding scale based on your income. Almost all rehabilitation centers offer some amount of financial assistance. Outpatient care and methadone or buprenorphine treatments may be more affordable than inpatient programs.[12]To find free or low-cost rehabilitation in the United States, call the Substance Abuse and Mental Health Services Administration.

You can also look up local treatment centers with the Behavioral Health Treatment Services Locator on their website.

You can also use their website to locate centers near you that dispense methadone and buprenorphine.

I have been taking 75 mcg Fentanyl patches, one every three days and 15 mg morphine pills two times a day for three-and-a-half years. I have severe back pain from a horse riding accident. How can I get off them?

What should I do if I am in the first stage of Alzheimer's and I want to get off oxycodone, but it gives me clarity?

Elwood T. Jones

In what way does it give you clarity? I found that after I started taking Oxycodone I became more and more fuzzy over time. I recommend you stop taking taking it before you develop a serious addiction like I have. Talk to your doctor about your options.

"This page was very helpful for me. I've been on the patch for over 15 yrs with over 60 knee operations and pins and the pain at times even with the patch sucks, but it's time for me to find something better. With the patch, you truly have no life. You can't swim or bathe without it falling off, not to mention that they fall off if you sweat too much. Getting off the patch is a real good thing for your body."..." more

A

Anonymous

Jun 17

"I have been on fentanyl patches over 14 years. I am receiving no help from my Dr., so about a year ago I started reducing from 125 to now 75 and I am about to take it down to 50. I have reduced or stopped several other meds. Norco from 10 to 5, now to nearly 0."..." more

BC

Bob Crane

May 20

"Just reduced Fentanyl patch by 12.5 its been 5 days, so far no real side effects."